What question did this study set out to answer?

June 12, 2012DiabetesOpen Access

Postprandial Platelet Activation Is Related to Postprandial Plasma Insulin Rather Than Glucose in Patients With Type 2 Diabetes

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Why the study?

Does premeal insulin aspart reduce postprandial platelet activation in patients with type 2 diabetes mellitus?

Population

18 patients with type 2 diabetes mellitus (T2DM)

Comparison

Premeal injections of insulin aspart vs Premeal injections of placebo

Design

RCT, randomized, cross-over, double-blind

Follow-up

90 min after the meal

Authors

GSGalia SpectreTel Aviv University CÖClaes‐Göran ÖstensonKarolinska University Hospital NLNailin LiKarolinska University Hospital

Discussion

Member takes

Implication

Premeal insulin aspart may augment postprandial platelet activation in T2DM; challenges assumptions of benefit and extends mechanistic evidence on insulin effects.

Key Points

To investigate whether meal-induced platelet activation in patients with type 2 diabetes mellitus is attenuated by premeal insulin administration.
Randomized, double-blind, cross-over study in 18 patients with type 2 diabetes mellitus comparing premeal injections of placebo versus insulin aspart (0.1 and 0.2 units/kg).
Standardized premeal blood glucose to 6-7 mmol/L with insulin infusion as needed, followed by flow cytometric measurement of platelet activation at baseline and 90 minutes postmeal with or without ADP or U46619 stimulation.
Premeal insulin reduced postprandial hyperglycemia by 2-3 mmol/L compared with placebo, but further elevated postmeal plasma insulin concentrations.
A standardized meal increased U46619-induced platelet P-selectin expression by 23% after placebo, whereas premeal insulin more than doubled this response and increased fibrinogen binding by approximately 50-60%.
Postprandial platelet activation correlated positively with postprandial insulin levels and inversely with glucose levels.

Structured PICO

Does premeal insulin aspart reduce postprandial platelet activation in patients with type 2 diabetes mellitus?

Population

18 patients with type 2 diabetes mellitus (T2DM)

Intervention

Premeal injections of insulin aspart (0.1 and 0.2 units/kg)

Comparator

Premeal injections of placebo

Outcome

Postprandial platelet activation assessed by flow cytometry (P-selectin expression and fibrinogen binding, without and with stimulation by U46619 or ADP) at 90 min after the mealsurrogate

Postprandial insulin levels, rather than glucose levels, appear to drive postprandial platelet activation in patients with type 2 diabetes.

Cite This Study

Spectre et al. (2012) studied this question.

synapsesocial.com/papers/6a868f6c7b9822affc8b8b94 https://doi.org/10.2337/db11-1806

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Implication

Premeal insulin aspart may augment postprandial platelet activation in T2DM; challenges assumptions of benefit and extends mechanistic evidence on insulin effects.

Postprandial Platelet Activation Is Related to Postprandial Plasma Insulin Rather Than Glucose in Patients With Type 2 Diabetes

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Postprandial Platelet Activation Is Related to Postprandial Plasma Insulin Rather Than Glucose in Patients With Type 2 Diabetes

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Also Consider